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Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study

Published online by Cambridge University Press:  21 November 2016

Manasi Sharma*
Harvard T. H. Chan School of Public Health
Shoshanna L. Fine
Harvard T. H. Chan School of Public Health
Robert T. Brennan
Harvard T. H. Chan School of Public Health
Theresa S. Betancourt
Harvard T. H. Chan School of Public Health
Address correspondence and reprint requests to: Manasi Sharma, Department of Social and Behaviors Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115; E-mail:


This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10–17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.

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